Abstract
Background
We aimed to assess characteristics, treatment, and outcomes of rectal melanoma (RM).
Methods
This retrospective cohort study looked at patients with RM from National Cancer Database
(2004–2019) analyzed characteristics and outcomes of the entire cohort and across
three time periods (2004–2009; 2010–2014; 2015–2019). Main outcome measures were change
in treatment and survival trends across time periods and overall survival (OS).
Results
641 patients (58.5% female; mean age: 68.2 ± 13.6 years) were included. OS rate was
26%; median survival duration was 17.9 (IQR: 15.93–20.67) months. There was a significant
decrease in the use of chemotherapy (17.3%–6.6%; p = 0.001) and surgery (62.9%–41.8%;
p = 0.00004) but increased use of immunotherapy (11.9%–52%; p < 0.001) across time
periods. OS was longer in the last time period than in the first two (21.8 vs 16.8
vs 16.5 months; p = 0.09). Surgical excision was an independent predictor of improved
OS (HR = 0.266, 95%CI: 0.089–0.789, p = 0.017) whereas older age (HR = 1.039, 95%CI:
1.007–1.072, p = 0.016), positive resection margins (HR = 5.06, 95%CI: 1.902–13.48,
p = 0.001) and metastasis (HR = 34.62, 95%CI: 3.973–301.6, p = 0.001) were predictors
of poor survival.
Conclusions
Over time, chemotherapy and surgery have been used less often in the treatment of
RM while the use of immunotherapy increased by more than four-fold. Older age, surgical
treatment, positive resection margins, and metastasis were predictive of survival
of RM.
Keywords
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Article info
Publication history
Accepted:
January 18,
2023
Received in revised form:
December 10,
2022
Received:
October 23,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Ltd.
